Tuesday, 27 January 2004

Questions (531)

Phil Hogan


646 Mr. Hogan asked the Minister for Health and Children if his attention has been drawn to the fact that elderly persons having their health board provided resources reduced, are being told that the reason for this measure is that the health board have inadequate funding to sustain the level of services originally deemed as necessary for their needs by the health board; if he has a strategy to assist the health boards; and if he will make a statement on the matter. [1133/04]

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Written answers (Question to Minister for Health and Children)

I wish to inform the Deputy that the aim of the home help service is to enable people to remain living at home, where appropriate, who would otherwise need to be cared for in long-stay residential care and that this service is an essential support to families and informal carers. The home help service by its nature is a flexible service which is designed to respond to clients' needs. The service is targeted at high and medium dependency clients in accordance with their assessed need. As a result, therefore, the level of service required in individual cases will fluctuate from time to time. To ensure effective prioritisation of the service, assessments are undertaken at local sector level and are carried out by the public health nursing services.

There are a number of reasons why demand for home help service have been increasing, such as demographic factors. Approximately 6,000 additional people come into the over-65 bracket every year and that there has been a proportionately higher percentage increase in the more dependent over-80 category. These factors may necessitate some minor adjustments in the provision of the home help service. Basically, what this means is that, although a small percentage of clients may have had their hours reduced, this has been counter-balanced by others receiving the service for the first time. I have been assured by all health boards that the provision of the home help service is organised on the basis that the most vulnerable clients are given priority.

The following table illustrates funding allocated to the home help service by health board area in 2003 and the percentage increase in funding for this service as compared with 2000:

Authority/Health Board

Expenditure in 2003 on Home Help Service

Percentage Increase in Expenditure since 2000


Eastern Regional Health Authority



Midland Health Board



Mid-Western Health Board



North Eastern Health Board



North Western Health Board



South Eastern Health Board



Southern Health Board



Western Health Board





The total increase in expenditure on the home help service across all health board areas since 2000 is 113.59%. The Deputy might also wish to note that an additional €3.748 million has been allocated by my Department to this service in 2004.

Since my appointment as Minister of State I have been encouraging the authority and the health boards to introduce home care packages including home based subvention for clients applying for nursing home subvention as an alternative to long-stay residential care. The criteria that applies for home based subvention is the same that applies for nursing home subvention. I am pleased to advise that a number of health boards are developing personal care packages that are more focussed on individual care needs, for example, public health nurse service, attendance at day care, day hospital and rehabilitation, and the provision of respite care, home help and care assistance.

In respect of the specific case referred to by the Deputy, the provision of health services in County Wexford rests with the South Eastern Health Board. My Department has, therefore, asked the chief executive officer of the board to investigate the matter raised by the Deputy and reply direct to him as a matter of urgency.